Organization
KTP FOOT AND ANKLE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN THANG DINH PHAM DPM (PRESIDENT)
(714) 654-4607
Entity
Organization
Contact information
Practice address
1855 N FAIR OAKS AVE # 200, PASADENA, CA 91103-1620
(626) 398-6300
Mailing address
9392 RUSSELL AVE, GARDEN GROVE, CA 92844-2354
(714) 654-4607
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508427972
NPI
CA
Enumeration date
06/26/2019
Last updated
03/22/2020
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